Growth Kinetics of Venous Tumor Thrombus from Renal Cell Carcinoma

No AccessJournal of UrologyOriginal Clinical Article26 Aug 2025Growth Kinetics of Venous Tumor Thrombus from Renal Cell Carcinoma Matthew T. McLeay, Daniel S. Roberson, Maddy Dorr, Gianni A. Morales-Martinez, Spyros P. Basourakos, Timothy L. Kline, John Cheville, Abhinav Khanna, Theodora A. Potretzke, Stephen A. Boorjian, Bradley C. Leibovich, and Vidit Sharma Matthew T. McLeayMatthew T. McLeay Corresponding Author: Matthew T McLeay II Email: ([email protected]) Professional Address: 200 First St SW, Rochester, MN, 55905 Phone number: 402-669-7335 https://orcid.org/0000-0001-8127-7746 , Daniel S. RobersonDaniel S. Roberson Department of Urology, Mayo Clinic, Rochester, MN, USA , Maddy DorrMaddy Dorr Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA , Gianni A. Morales-MartinezGianni A. Morales-Martinez Department of Urology, Mayo Clinic, Rochester, MN, USA , Spyros P. BasourakosSpyros P. Basourakos Department of Urology, Mayo Clinic, Rochester, MN, USA , Timothy L. KlineTimothy L. Kline Department of Radiology, Rochester, MN, USA , John ChevilleJohn Cheville Department of Pathology, Mayo Clinic, Rochester, MN, USA , Abhinav KhannaAbhinav Khanna Department of Urology, Mayo Clinic, Rochester, MN, USA , Theodora A. PotretzkeTheodora A. Potretzke Department of Radiology, Rochester, MN, USA , Stephen A. BoorjianStephen A. Boorjian Department of Urology, Mayo Clinic, Rochester, MN, USA , Bradley C. LeibovichBradley C. Leibovich Department of Urology, Mayo Clinic, Rochester, MN, USA , and Vidit SharmaVidit Sharma Department of Urology, Mayo Clinic, Rochester, MN, USA View All Author Informationhttps://doi.org/10.1097/JU.0000000000004750AboutPDF Cite Export CitationSelect Citation formatNLMAMAIEEEACMAPAChicagoMLAHarvardTips on citation downloadDownload citationCopy citation ToolsAdd to favoritesTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: Renal cell carcinoma (RCC) is known to form venous tumor thrombus (VTT); however, limited data exist on VTT growth rates. We sought to characterize the growth rate of VTTs from RCC and identify clinicopathologic features associated with faster thrombus growth. Materials and Methods: Systemic therapy naïve patients with RCC and VTT with two pre-operative imaging studies performed with contrast at least 7 days apart were identified from a single institutional registry. VTT levels were assigned using the Mayo classification and measured in millimeters (mm). Changes between scans were linearized to growth rate per day. Multivariable regression models identified factors associated with VTT growth. Results: We evaluated 141 patients with a median time between scans of 20 days (IQR 12-30) and noted a median VTT growth rate of 0.3mm/day. Sixteen (11%) patients were reclassified on the second scan to a higher Mayo VTT level. There was a significant relationship between VTT growth and increasing tumor thrombus level (p<0.001) as well as the presence of sarcomatoid/rhabdoid features (0.4 vs 0.3 mm/day, p=0.003). On multivariable regression, there is a quadratic increase in VTT growth rates as thrombus level increases (p=0.001). Sarcomatoid/rhabdoid features (coefficient +0.43mm/day, p<0.001) and metastatic disease (coefficient +0.30mm/day, p=0.03) were also associated with increased tumor thrombus growth rates. Conclusions: VTT growth is generally less than 1mm/day, although higher level thrombi and disease with aggressive histopathology grew more rapidly. These data improve the understanding of tumor thrombus growth and can aid in pre-operative triage and surgical planning. © 2025 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2025 by American Urological Association Education and Research, Inc.KeywordsRenal cellcarcinomathrombosisinvasivenesskidney neoplasms Author Information Matthew T. McLeay Corresponding Author: Matthew T McLeay II Email: ([email protected]) Professional Address: 200 First St SW, Rochester, MN, 55905 Phone number: 402-669-7335 More articles by this author Daniel S. Roberson Department of Urology, Mayo Clinic, Rochester, MN, USA More articles by this author Maddy Dorr Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA More articles by this author Gianni A. Morales-Martinez Department of Urology, Mayo Clinic, Rochester, MN, USA More articles by this author Spyros P. Basourakos Department of Urology, Mayo Clinic, Rochester, MN, USA More articles by this author Timothy L. Kline Department of Radiology, Rochester, MN, USA More articles by this author John Cheville Department of Pathology, Mayo Clinic, Rochester, MN, USA More articles by this author Abhinav Khanna Department of Urology, Mayo Clinic, Rochester, MN, USA More articles by this author Theodora A. Potretzke Department of Radiology, Rochester, MN, USA More articles by this author Stephen A. Boorjian Department of Urology, Mayo Clinic, Rochester, MN, USA More articles by this author Bradley C. Leibovich Department of Urology, Mayo Clinic, Rochester, MN, USA More articles by this author Vidit Sharma Department of Urology, Mayo Clinic, Rochester, MN, USA More articles by this author Expand All Advertisement PDF downloadLoading ...